Individual
SUSAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7412 WALKER AVE, GLOUCESTER, VA 23061-6131
(804) 832-8682
Mailing address
3703 WOODSTOCK RD, GLOUCESTER, VA 23061-3032
(804) 832-8682
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
VA
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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